Effect of oral contrast for abdominal computed tomography on emergency department length of stay

被引：28

作者：

Schuur J.D. ^{[1
,2
]}

Chu G. ^{[2
]}

Sucov A. ^{[2
,3
]}

机构：

[1] Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115

[2] Department of Emergency Medicine, Brown Medical School, Providence, RI

[3] Department of Quality Management, Rhode Island Hospital, Providence, RI

来源：

Emergency Radiology | 2010年 / 17卷 / 4期

关键词：

Contrast media; Hospital emergency service; Length of stay; X-ray computed tomography;

D O I：

10.1007/s10140-009-0847-1

中图分类号：

学科分类号：

摘要：

Computed tomography of the abdomen and/or pelvis (CTAP) is frequently used in the emergency department (ED) allowing diagnosis of a variety of conditions, but requiring a prolonged period of preparation. To determine whether not requiring oral contrast for CTAP reduces ED length of stay (LOS). Retrospective cohort of adult patients visiting an academic ED over 13 weeks around a radiology protocol change. Before the change, many CTAPs required oral contrast; thereafter, oral contrast was not required. LOS was compared before and after the change among all adult ED patients. Among patients undergoing CTAP, adjusted LOS and time to CTAP were compared using multivariate linear regression. 20,464 adult ED visits occurred over the study period, including 1,806 where a CTAP was performed. Oral contrast usage decreased from 42.5% of CTAP to 12.2% (difference 30.3%, 95% confidence interval 38.7% to 46.3%). There was no change in LOS among all ED visits. Among ED visits where a CTAP was performed, median time to CTAP decreased by 27 min and median LOS decreased by 30 min. Adjusted LOS decreased from 324 min (312-337) to 297 min (285-309). Not routinely requiring oral contrast for CTAP in the ED is associated with a half-hour reduction in LOS among all patients undergoing CTAP. © Am Soc Emergency Radiol 2009.

引用

页码：267 / 273

页数：6

共 28 条

[1]

McCaig L.F., Nawar E.N., National Hospital Ambulatory Medical Care Survey: 2004 Emergency Department Summary, (2006)

[2]

Torbati S.S., Guss D.A., Impact of helical computed tomography on the outcomes of emergency department patients with suspected appendicitis, Acad Emerg Med, 10, pp. 823-829, (2003)

[3]

Ahn S.H., Mayo-Smith W.W., Murphy B.L., Et al., Acute nontraumatic abdominal pain in adult patients: Abdominal radiography compared with CT evaluation, Radiology, 225, pp. 159-164, (2002)

[4]

Rao P.M., Rhea J.T., Novelline R.A., Et al., Effect of computed tomography of the appendix on treatment of patients and use of hospital resources, N Engl J Med, 338, pp. 141-146, (1998)

[5]

Rosen M.P., Sands D.Z., Longmaid III H.E., Et al., Impact of abdominal CT on the management of patients presenting to the emergency department with acute abdominal pain, Am J Roentgenol, 174, pp. 1391-1396, (2000)

[6]

Brown J., Shesser R., Computed tomography scan use in the emergency department evaluation of patients with nonspecific abdominal pain is increasing despite decreased patient acuity, Acad Emerg Med, 12, 5 SUPPL., (2005)

[7]

Hustey F.M., Meldon S.W., Banet G.A., Et al., The use of abdominal computed tomography in older ED patients with acute abdominal pain, Am J Emerg Med, 23, pp. 259-265, (2005)

[8]

Nagurney J.T., Brown D.F.M., Chang Y., Et al., Use of diagnostic testing in the emergency department for patients presenting with non-traumatic abdominal pain, J Emerg Med, 25, pp. 363-371, (2003)

[9]

Lee S.I., Chew F.S., Radiology in the emergency department: Technique for quantitative description of use and results, Am J Roentgenol, 171, pp. 559-564, (1998)

[10]

Rodi S.W., Grau M.V., Orsini C.M., Evaluation of a fast track unit: Alignment of resources and demand results in improved satisfaction and decreased length of stay for emergency department patients, Qual Manage Health Care, 15, pp. 163-170, (2006)

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